• J Mathieu, J-P Pertek, S Brua, Z Samia, and M R Losser.
• Service de réanimation chirurgicale, département d'anesthésie-réanimation, institut lorrain du cœur et des vaisseaux Louis-Mathieu, CHU de Nancy, université de Lorraine, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.
• Ann Fr Anesth Reanim. 2013 Dec 1; 32 (12): 879-81.

AbstractA 79-year-old man with atherosclerosis presented blue toes and livedo reticularis. The patient had eroded aortic atheromatous plaques, and cholesterol embolization syndrome was suspected. An endovascular technique to exclude sources of cholesterol emboli was however performed. The patient immediately presented with severe muscle pain and total functional disability of lower limbs, new ischemic lesions of toes, anal and genital necrosis, and a livedo extended up to the abdomen. A massive rhabdomyolysis occurred associated with acute kidney injury and hyperkaliemia treated by continuous renal replacement therapy with regional citrate anticoagulation. Steroids have been introduced and renal function improved. Cholesterol crystals were also found on a skin biopsy, performed before endovascular procedure. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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